Oxford Transplant Centre

The transplant procedures undertaken at the Oxford Transplant Centre include kidney transplantation, pancreas transplantation and pancreatic islet transplantation. We have strong links with the Nuffield Department of Surgery at the John Radcliffe Hospital, and we work closely with the Donor Transplant Coordinators.

Procedures we carry out

Kidney transplantation

Kidney transplantation is performed using kidneys retrieved from either deceased ('cadaveric') or live organ donors. The transplant procedure may be performed on patients with kidney failure due to a large variety of causes, but the most common are diabetes, inherited polycystic kidney disease, glomerulonephritis and pyelonephritis.

About 100 patients a year receive a kidney transplant at Oxford, and the region serves stretches between Swindon in the south, Gloucester in the west, High Wycombe in the east and Banbury in the north.

Pancreas transplantation

Pancreas transplantation is a procedure usually performed to treat patients who have a failure of their pancreas to produce insulin, most often due to 'type 1' diabetes, where the insulin secreting cells which are normally scattered throughout the pancreas in clusters called 'islets' have been destroyed by their own immune system - an autoimmune disease.

Pancreas transplantation is performed using pancreases retrieved from cadaveric organs, and is carried out in a similar way to a kidney transplant, by joining the blood vessels to those of the patient receiving the transplant.

Most patients receive their pancreas at the same time as a kidney transplant, a procedure called 'simultaneous kidney/pancreas graft' (SPK). This is usually the best option for patients who have kidney failure caused by long-term diabetes. Some diabetic patients who have had a previous kidney transplant then go on later to have a pancreas transplant ('pancreas after kidney (PAK)'). Occasionally patients who have found severe difficulties controlling their diabetes and have early signs of kidney failure are transplanted with a 'pancreas transplant alone' (PTA).

Oxford Transplant Centre is one of seven national centres performing pancreas transplantation. Patients come from as far afield as Portsmouth, Bristol, Dorset and London.

Pancreatic islet transplantation

This is a procedure which is considered experimental in Oxford, as the clinical protocols and necessary laboratory procedures are still in the process of development. However, in a number of centres around the world the procedure is now in routine clinical practice, and it is hoped this will be the case in Oxford in the near future.

Islet transplantation in patients with diabetes involves separating out the insulin-producing islet tissue from within the pancreas and transplanting the islets as a simple injection into the liver, where they develop their own blood supply and produce insulin as required.

The aim is to replace pancreas transplantation with an islet graft, but the process is not yet advanced enough to allow single donor transplantation. However, certain diabetic patients, who have major problems with hypoglycaemia and contraindications to vascularised pancreas transplantation, can be considerably improved by islet transplantation.

For further information on pancreatic islet transplantation please contact:

Intestinal transplantation / small bowel transplant

Intestinal transplantation is an operation to replace diseased or shortened bowel with the healthy bowel from a donor. Small bowel transplant may be an option for those individuals whose bowel no longer works and who are dependent on being fed via total parenteral nutrition (TPN) - liquid feed via a vein into the body.

It may become necessary for some individuals on TPN to consider a small bowel transplant if their liver shows signs of damage from the TPN, or if they have problems with intravenous line infections, or even lose line access.

Bowel transplants have been performed in Oxford since 2008 and internationally since the 1960s. Following small bowel transplant patients can be weaned off TPN on to a normal oral diet.

A multidisciplinary team approach is paramount in the success of the transplant. Patients are rigorously assessed by a multidisciplinary team before being deemed fit for the operation.

Small bowel transplantation is a complicated and difficult operation that comes with risks. In the past there were high rates of rejection of the new organ. In recent times, with the development of medicines to manage rejection, immunosuppression and greater experience, survival rates are improving.

For further information on intestinal transplantation / small bowel transplant please contact: